| Course | NU 672 Counseling and Psychotherapy |
|---|---|
| Unit | Unit 7 |
| Paper type | Treatment review and revision brief |
| Length | About 620 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 672 Unit 7
Treatment Review at Session 10: Panic Disorder Therapy After a Family Crisis, With Goals Held to Their Original Wording
Student Name
Department of Nursing, Herzing University
NU 672: Counseling and Psychotherapy
Instructor Name
March 4, 2026
Treatment Review at Session 10: Panic Disorder Therapy After a Family Crisis, With Goals Held to Their Original Wording
Why a Review Now
The treatment plan scheduled a formal review at session 8. It was moved to session 10 because session 8 was taken up by Ms. J.'s disclosure about her nephew and the child abuse report that followed. Since then, she has had two panic attacks and asked for an extra session. Ms. J., a composite patient, is being treated for panic disorder with avoidance of highways and crowds. Her sister's wedding, the goal she named first, is seven weeks away. The review asks whether the course is on track, and whether to continue, adjust, or refer. Routine measurement of outcomes during therapy, with results compared against expected progress, helps identify patients who are not improving as expected, before they drop out or deteriorate (Lambert, 2013).
The Goals, Held to the Original Plan, and Where Each Stands
Each goal is identified by its number and key words from the plan agreed at the start, unchanged, with the evidence against it.
| Goal, key words from the original plan | Expected by session 10 | Evidence | Status |
|---|---|---|---|
| 1. "why it isn't a heart attack" | Met | Her rated belief in a cardiac cause fell from 70 to 25 | Met |
| 2. "ride it out without leaving" | Met | Peak fear during exercises down from 70 to 30; Anxiety Sensitivity Index-3 from 38 to 20 | Met |
| 3. "stay until I finish shopping" | Met | Completed three Saturday trips | Met |
| 4. "on the interstate alone, 20 minutes" | Met or close | Drove a 20-minute highway segment with the therapist in session 10; drove 10 minutes alone once since | Partly met |
| 5. "don't carry lorazepam anymore" | In progress | Moved to the glove compartment; taken once, the evening after the report | Partly met |
| 6. "drove to my sister's wedding" | Not yet expected | Wedding in seven weeks | Pending |
| 7. "back to full-time work" | Not yet expected | Still part-time | Pending |
| 8. "what to do if an attack happens" | Not yet expected | Plan not yet written | Pending |
Overall Measures Against Expectation
Panic Disorder Severity Scale (Shear et al., 1997): 16 at baseline, 10 at session 7, and 11 now. A published guide to interpreting the scale relates scores in the low teens to moderate illness and lower scores to milder illness (Furukawa et al., 2009). The expected trajectory for a patient engaged in exposure at this point was continued decline toward the single digits. The score has instead leveled off over the last three sessions, and the two attacks in the past two weeks follow a month with only one.
The honest reading is that the first half of treatment worked as planned, and that progress has stalled since the family crisis. Goals 1 to 3 are met; the driving and lorazepam goals, which were expected to be met or close, are only partly met; and panic frequency has risen.
Understanding the Stall
Two explanations fit. First, the report and its aftermath, her nephew staying with his grandmother, conflict with her sister, the wedding in doubt for a week, are a major stressor, and panic often increases under stress. Second, the event touched a theme noted earlier: her sister's upcoming move and her own fear of loss. Her statement in session 9 that "every time I speak up, something falls apart" suggests a belief that may now be driving avoidance in general, not only on the highway. Neither explanation means the approach has failed; both suggest it needs adjustment.
The Decision
Continue, with adjustments. First, add four sessions to the planned twelve, weekly through the wedding, focused on graded highway driving toward a one-hour practice drive two weeks before the wedding. Second, use two sessions to address the belief that speaking up causes loss, with cognitive techniques applied to that belief and attention to her feelings about her sister, since these now appear connected to her attacks. Third, write the relapse prevention plan now rather than at the end, given the continuing family stress. Fourth, speak with her prescriber about the lorazepam, with her agreement, so that its use after the report does not become a pattern.
Conditions for Changing Course
Refer for evaluation of an antidepressant, which she declined at the start but said she would reconsider, if the severity score is 11 or higher at session 13, or if attacks increase further. Refer for trauma-focused assessment if intrusive memories of the incident with her nephew, nightmares, or avoidance related to it appear. Consider a different therapeutic approach, such as panic-focused psychodynamic work on the separation theme, if exposure progresses but attacks persist. Next review: session 13, three weeks before the wedding.
References
Furukawa, T. A., Shear, M. K., Barlow, D. H., Gorman, J. M., Woods, S. W., Money, R., Etschel, E., Engel, R. R., & Leucht, S. (2009). Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depression and Anxiety, 26(10), 922-929. https://doi.org/10.1002/da.20532
Lambert, M. J. (2013). Outcome in psychotherapy: The past and important advances. Psychotherapy, 50(1), 42-51. https://doi.org/10.1037/a0030682
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., Gorman, J. M., & Papp, L. A. (1997). Multicenter collaborative Panic Disorder Severity Scale. American Journal of Psychiatry, 154(11), 1571-1575. https://doi.org/10.1176/ajp.154.11.1571
Reading the NU 672 Unit 7 instructions
Unit 7 asks you to review a patient's progress in therapy and decide whether to continue, adjust or change course. Expect to explain the timing of the review, report each goal's status against its original wording, present overall measures against expectations, interpret any stall, make a decision and set conditions for further change. Many versions ask how much change counts as progress. Check whether your section requires a formal measure. Holding goals to their original wording prevents quietly redefining success. Published benchmarks for the outcome measure help judge whether change is meaningful. Referral or added treatment is not a failure of therapy, so present it as a possible step rather than a last resort.
How the NU 672 Unit 7 example is put together
The brief opens by explaining why the review happened when it did, which ties it to the earlier crisis. Goals are listed with their original wording and status, so the reader can see which moved and which stalled. Overall measures are compared with a published benchmark for meaningful change. The stall section offers two explanations and the evidence for each. The decision section is specific: four added sessions with a stated focus. The conditions section sets thresholds for referral or other changes, so the next review has clear criteria. The brief stays short and factual, which suits a document meant to guide the next sessions and to be read by a supervisor.
Reading the NU 672 Unit 7 rubric
Herzing's rubric for a treatment review usually covers the timing and purpose, the status of goals, use of outcome measures, interpretation, the decision and conditions for change. Goal status is read against the original plan, and graders notice when goals are reworded to look met. Measure points reward validated scales compared with baseline and benchmarks. Interpretation criteria look for plausible explanations with evidence. Decision points go to specific adjustments with reasons. Conditions for change earn credit when they are measurable. Writing covers concise, factual organization. Furukawa's study and Lambert's review belong in the APA 7 references. Including the patient's view of progress, and her agreement to the adjustment, is often credited within the decision row.
NU 672 Unit 7 help before you submit
Treatment reviews in Unit 7 tend to slip when goals are restated more loosely than in the original plan, which makes progress look better than it is. Another frequent problem is reporting a scale score without comparing it with baseline or a benchmark. Students often explain a stall in one sentence. The decision is vague, such as continue therapy. Conditions for changing course are missing. Referral is framed as failure. Patient input into the decision is left out. Finally, hold yourself to the original goals, because graders reward reviews that show honest measurement against the plan rather than a narrative that adjusts the plan to fit the results. The review also needs a date for the next check, or the conditions for change have no point at which to be applied.
Get a NU 672 Unit 7 example written to your instructions
Send the Unit 7 instructions and the rubric from your NU 672 classroom, together with the goals the therapy started from. We write a custom example that quotes those goals unchanged, separates evidence by source, sets the conditions for continuing, adjusting or referring, and records the conversation with the client. First custom sample free, back inside 24 to 48 hours.
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NU 672 Unit 7 questions, answered
How much change counts as progress?
Whatever the goals said it would, which is why the original wording matters so much. A target written as feeling better cannot be judged, and a review inherits that problem. Where the starting goals were vague, say so in the brief and describe the change concretely instead: what the person does now that they did not before, and how often.
Is referral a failure of the therapy?
It is generally treated as a clinical judgment rather than a verdict on the practitioner, and papers written as though it were an admission tend to avoid the option entirely. State what this approach was aimed at, what has not moved, and what a different approach or setting offers that this one structurally does not. Any statement about what a specific service accepts should be checked locally.
Should the review include a formal measure?
Follow the instructions. Where a measure is required, name it, say who completed it and when, and report the result even when it disagrees with your impression, because that disagreement is often the most interesting part of the brief. Where none is required, observation described in specific behavioral terms carries the same weight and is usually easier to defend.
Where can I find a free NU 672 Unit 7 sample paper?
The full NU 672 Unit 7 session 10 review is on this page free of charge, goals against their original wording, measures and the decision. A review for a different patient or approach can be written on request.
How do I know if therapy is working?
Compare a validated measure with baseline and a published benchmark for meaningful change, and check each goal against its original wording. This sample finds the panic severity score stalled at 10 to 11 after a family crisis and adjusts the plan.